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Individual

DR. THADDEUS MICHAEL MIDAS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PH.D.

Contact information

Practice address
701 BRIDGE ST, SUITE 206, LEHIGHTON, PA 18235-1800
(610) 377-6155
(610) 377-9765
Mailing address
701 BRIDGE ST, SUITE 206, LEHIGHTON, PA 18235-1800
(610) 377-6155
(610) 377-9765

Taxonomy

Speciality
Code
Description
License number
State
103TP2701X
Group Psychotherapy Psychologist
Primary
PS003455-L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
4455111
AETNA
PA
01
50008809
CAPITAL BLUE CROSS
PA
01
818748
NORTHEAST BLUE CROSS BLUE SHIELD
PA
Enumeration date
03/21/2006
Last updated
12/10/2013
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